3416P

Procedure – Medication at School

Each school principal in consultation with the school Registered Nurse (RN), will authorize, at the minimum, two staff members to administer all medications including prescribed and over-the-counter medications.  These designated staff members will receive RN delegation and training prior to the opening of school each year.

For the purposes of this procedure, “medication” means oral medication, topical medication, eye or ear drops and nasal spray.  This definition does not include over-the-counter topical sunscreen products regulated by the US Food and Drug Administration (see Sunscreen section below).   Oral medications are administered by mouth either by swallowing or inhaling and may include administration by mask if the mask covers the mouth or mouth and nose.

Medication may be dispensed to students on a scheduled basis upon written authorization from a parent with a written request by a licensed health professional (LHP) prescribing within the scope of their prescriptive authority. The written authorization must be accompanied by dosage instructions from the LHP. Requests shall be valid for not more than the current school year. All new orders for medication or medication order changes must be approved by the supervising RN prior to school staff administering the first dose. All medications must be properly labeled and be contained in the original container.

Individuals administering medication will:

1. Collect the medication in original container directly from the parent/guardian (students should not transport medication to and from school except for medications needed for the treatment of medical emergencies). Collect a medication request and authorization form properly signed by the parent/guardian and by the LHP including instructions from the LHP.
2. Count the medication and record the number of pills or the amount of liquid medication received, with initials and date received, on the medication log. It is preferable to have two people count and initial.
3. Counting of controlled substances at least weekly as recommended by the Board of Pharmacy. On weekly medication counts, the nurse must have assistance and a witness to the actual count of the medications.
4. Store the medications (not more than a twenty (20) day supply) in a locked, substantially constructed cabinet or limited access area;
5. Maintain a current record which indicates that the medication was administered. If a dose is missed, note the reason, e.g. “absent.” This record must be kept for 8 years.
6. Medications may not be given after the date specified on the authorization form or expiration date on the label; and
7. Report medication errors to the school nurse immediately.

Provide for supervision by a physician or registered nurse.

A copy of this policy will be provided to the parent/guardian upon request.

Oral or topical medications, eye drops, ear drops, or nasal spray may be administered by a registered nurse, licensed practical nurse or designated staff who are delegated to, trained and supervised by the RN.

Nasal sprays containing controlled substances may only be administered by a school nurse if a school nurse is in the building. If a school nurse is not present on school premises, the task may be delegated to an authorized and trained school employee as stated in RCW 28A.210.330.  A parent-designated adult with training as required by RCW 28A.210.260 may also administer the medication when a nurse is not in the building. After a school employee who is not a school nurse administers a nasal spray that is a controlled substance, the employee must summon emergency medical assistance as soon as practicable except in instances when the administration of the nasal spray occurs routinely as documented in emergency care plan signed by parent or guardian and LHP.

No medication will be administered by injection by unlicensed school staff except when a student is susceptible to a life-threatening anaphylactic condition consistent with policy and procedure 3419 Self Administration of Asthma and Anaphylaxis Medications, and policy and procedure 3420 Anaphylaxis Prevention and Response, when acting as a parent designated adult for students with diabetes, or when acting as a designated trained responder for opioid overdose reversal medication administration consistent with policy and procedure 3424 Opioid Related Overdose Reversal.

When any life-saving medication (such as an epi-pen or narcan) is administered, nursing or office staff are directed to call 911 to summon emergency medical assistance as soon as possible.

The parent will submit a written authorization to act according to the specific written orders and supporting directions provided by a licensed health professional prescribing within his or her prescriptive authority (e.g., medication administered to counteract a reaction to an insect sting). Such medication will be administered by staff trained by the supervising registered nurse to administer such an injection.

Written orders for emergency medication, signed and dated, from the licensed health professional will:

1. State that the student suffers from a health condition which may result in an emergency;
2. Identify the drug, the mode of administration and the dose.
3. Indicate when the medication will be administered based on anticipated or actual symptoms;
4. Recommend follow-up after administration, administration of additional medications, transport to hospital; and
5. Specify how to report to the health professional and any record-keeping recommendations.

If a health professional and a student’s parent request that a student be permitted to carry his/or her own medication and/or be permitted to self-administer the medication, the principal may grant permission after consulting with the school nurse. The process for requesting and providing instructions will be the same as established for oral medications. The principal and nurse will take into account the age, maturity and capability of the student, the nature of the medication, the circumstances under which the student will or may have to self-administer the medication and other issues relevant in the specific case before authorizing a student to carry and/or self-administer medication at school. Except in the case of multi-dose devices (like asthma inhalers), students will only carry one day’s supply of medication at a time. Violations of any conditions placed on the student permitted to carry and/or self-administer his or her own medication may result in termination of that permission, as well as the imposition of discipline when appropriate.

The parent or legal guardian must sign a statement acknowledging that the district will incur no liability as a result of any injury arising from the self-administration or carrying of medication by the student and that the parents or legal guardian will indemnify and hold harmless the district and its employees or agents against any claims arising out of the self-administration or carrying of medication by the student.

Medications for Emergency Closures

Parents/guardians are asked to identify medications that students normally take only at home where missing doses of the medication would pose a serious health risk for the student or others. In preparation for potential school closures where students are kept on site, it is recommended that the parent/guardian provide up to a three-day supply of these medications and the necessary parent/guardian and LHP authorization and instructions for these medications. These situations will be identified and addressed on an individual basis by the school nurse. 

Sunscreen

Over-the-counter topical sunscreen products may be possessed and used by students without a written prescription or note from a licensed health care provider, if the following conditions are met:

1. The product is regulated by the US Food and Drug Administration as an over-the-counter sunscreen product; and
2. If possessed by a student, the product is provided to the student by their parent or guardian.

Violations of any conditions placed on the student permitted to carry and/or self-administer his or her own sunscreen products may result in confiscation and termination of that permission, as well as the imposition of discipline when appropriate.

School staff may assist students in application of sunscreen products in certain circumstances and in the presence of another staff member. The appropriate staff member will take into account the age, maturity, and capability of the student, the need for the application of the sunscreen, and other issues relevant in the specific case, before assisting students in application of sunscreen products at school or during school-sponsored events. However, staff members are not required to assist students in applying sunscreen.

Parent-Designated Adult Care of Students with Epilepsy or Diabetes

 For information on parent designated adults see the following policies:

• 3411 – Accommodating Students with Seizure Disorders or Epilepsy
• 3415 – Accommodating Students with Diabetes

End of School Year Procedure

Two weeks prior to the end of the year:

1.  School nurses will notify parents/guardians to pick up any medication by noon on the last day of school.
2. Medications that have not been picked up on the last day of school will be counted and documented by the school nurse and one other witness.  The medication will then be destroyed. Destruction information will be documented on the Medication Authorization Form. Any controlled substances are taken to the police station for destruction, other medications are discarded in the proper waste/sharps receptacles.

Date: February 26^th, 2013; Revised January 22, 2019, January 28, 2025